@Article{info:doi/10.2196/jmir.1983,
author="Archambault, Michel Patrick
and Bilodeau, Andrea
and Gagnon, Marie-Pierre
and Aubin, Karine
and Lavoie, Andr{\'e}
and Lapointe, Jean
and Poitras, Julien
and Croteau, Sylvain
and Pham-Dinh, Martin
and L{\'e}gar{\'e}, France",
title="Health Care Professionals' Beliefs About Using Wiki-Based Reminders to Promote Best Practices in Trauma Care",
journal="J Med Internet Res",
year="2012",
month="Apr",
day="19",
volume="14",
number="2",
pages="e49",
keywords="Wiki; Collaborative writing applications; Web 2.0; traumatic brain injury; interprofessional collaboration; reminders; computerized clinical decision-support system; knowledge translation; evidence-based medicine; theory of planned behavior",
abstract="Background : Wikis are knowledge translation tools that could help health professionals implement best practices in acute care. Little is known about the factors influencing professionals' use of wikis. Objectives : To identify and compare the beliefs of emergency physicians (EPs) and allied health professionals (AHPs) about using a wiki-based reminder that promotes evidence-based care for traumatic brain injuries. Methods : Drawing on the theory of planned behavior, we conducted semistructured interviews to elicit EPs' and AHPs' beliefs about using a wiki-based reminder. Previous studies suggested a sample of 25 EPs and 25 AHPs. We purposefully selected participants from three trauma centers in Quebec, Canada, to obtain a representative sample. Using univariate analyses, we assessed whether our participants' gender, age, and level of experience were similar to those of all eligible individuals. Participants viewed a video showing a clinician using a wiki-based reminder, and we interviewed participants about their behavioral, control, and normative beliefs---that is, what they saw as advantages, disadvantages, barriers, and facilitators to their use of a reminder, and how they felt important referents would perceive their use of a reminder. Two reviewers independently analyzed the content of the interview transcripts. We considered the 75\% most frequently mentioned beliefs as salient. We retained some less frequently mentioned beliefs as well. Results : Of 66 eligible EPs and 444 eligible AHPs, we invited 55 EPs and 39 AHPs to participate, and 25 EPs and 25 AHPs (15 nurses, 7 respiratory therapists, and 3 pharmacists) accepted. Participating AHPs had more experience than eligible AHPs (mean 14 vs 11 years; P = .04). We noted no other significant differences. Among EPs, the most frequently reported advantage of using a wiki-based reminder was that it refreshes the memory (n = 14); among AHPs, it was that it provides rapid access to protocols (n = 16). Only 2 EPs mentioned a disadvantage (the wiki added stress). The most frequently reported favorable referent was nurses for EPs (n = 16) and EPs for AHPs (n = 19). The most frequently reported unfavorable referents were people resistant to standardized care for EPs (n = 8) and people less comfortable with computers for AHPs (n = 11). The most frequent facilitator for EPs was ease of use (n = 19); for AHPs, it was having a bedside computer (n = 20). EPs' most frequently reported barrier was irregularly updated wiki-based reminders (n = 18); AHPs' was undetermined legal responsibility (n = 10). Conclusions : We identified EPs' and AHPs' salient beliefs about using a wiki-based reminder. We will draw on these beliefs to construct a questionnaire to measure the importance of these determinants to EPs' and AHPs' intention to use a wiki-based reminder promoting evidence-based care for traumatic brain injuries. ",
doi="10.2196/jmir.1983",
url="http://www.jmir.org/2012/2/e49/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22515985"
}